Variability in Medicare reimbursement and resource intensity in end of life acute care.

This study explores whether ownership type of Texas general hospitals affects the total number of inpatient days consumed by chronically ill Medicare patients during their last two years of life. Data from the Dartmouth Atlas of Health Care (2008) used in the analysis reflect intensity of health care provided during the last two years of life to those who have severe chronic illnesses and are enrolled in traditional, or fee-for-service, Medicare and who became decedents during 2001 to 2005. Hospital days by type are attributable to the primary care facility. The analysis focuses on the difference in total days spent in general hospitals between Medicare patients whose primary hospital is for-profit (investor-owned) and those whose primary hospital is not-for-profit (owned by 501(c)(3) organizations and governmental entities) in Texas. We find no evidence of a difference in days hospitalized in this population after controlling for hospital referral region.